Parkland’s new Global Diabetes Program improves patient access, care
Patient-centered approach involves multidisciplinary team
Accessing care can be a major challenge for patients with diabetes. A complex disease, diabetes is difficult to manage and patients often need frequent interaction with medical providers. But the average patient spends less than six hours a year with a health care provider for diabetes management. With diabetes’ rates soaring, health care organizations are struggling to keep up with demand for services.
According to the American Diabetes Association, nearly 30 million Americans, almost 10 percent of the population, have diabetes, and it remains the 7th leading cause of death in the U.S. The number of people with diabetes in Texas is projected to quadruple from 2 million to nearly 8 million by 2040, according to the Texas Health Institute. November is Diabetes Awareness Month, designed to draw attention to this serious public health issue.
To address the challenge locally, Parkland Health & Hospital System has developed an innovative new program that “will transform diabetes care in Dallas County,” said Luigi Meneghini, MD, Professor of Internal Medicine at the University of Texas Southwestern Medical Center and Executive Director of the new Global Diabetes Program.
“Diabetes has reached epidemic proportions in America and in Texas,” Dr. Meneghini said. “Our mission is to educate, support and encourage a healthy lifestyle free of disease complications for people with diabetes. The Global Diabetes Program will provide a comprehensive approach to improve access to clinical care and more closely connect patients to care in their local communities.”
The program, which was launched in 2013 with the help of funding provided by the state’s 1115 waiver, is patient-centered and multidisciplinary, meaning that an entire team of physicians, nurses, psychologists, dietitians, pharmacists, social workers and financial experts “rotate around the patient, instead of making the patient adjust to the needs of the care providers,” Dr. Meneghini said. The goal is to address social, psychological, financial and medical barriers that get in the way of patients receiving the care they need.
The Global Diabetes Program was developed in collaboration with Parkland’s Community Oriented Primary Care (COPC) health centers and the Division of Endocrinology at UT Southwestern. Although still in its early stages, the number of patient visits for FY 2015 is expected to more than double compared with last year’s total of around 3,000 visits.
Patient Doris Mondragon, 46, of Dallas developed gestational diabetes when pregnant 13 years ago. She appreciates the regular contact with nurse navigator Theresa Lira, RN.
“Theresa calls me every two weeks to check on how I’m feeling and remind me of my clinic appointments,” Mondragon said. “The staff taught me how to give myself insulin injections and helped me find a primary care provider at the Parkland clinic near where I live. I’m really, really happy with the care at Parkland and I’m feeling better than I did before.”
Other team members include diabetes educators who teach patients diabetes self-management, from basic survival skills to insulin replacement with injections or insulin pumps. A clinical pharmacist helps patients with medication management and dietitians provide nutrition counseling. Psychosocial support was recently added to help patients deal with mental health issues, including depression, which can be associated with this chronic disease. Spanish-speaking staff and interpreters ensure that language does not become a barrier for patient care.
While patients can attend traditional visits with a nurse practitioner or physician, other methods of interacting with patients are being developed. One of the program’s innovations is the launch of virtual visits. A patient can have a 15-minute phone consult instead of having to get child care, find transportation to the doctor’s office and be away from work or home for several hours.
Next month the program will pilot shared medical appointments. Individuals with diabetes will have a chance to interact in a group setting, sharing their concerns and best practices with each other and the multidisciplinary team, and receive treatment and advice in the process.
“What is good for patients is also good for Parkland, which will benefit from reduced hospital admissions and lower cost of care,” Dr. Meneghini said.
For more information about the Global Diabetes Program at Parkland, please call 214.590.5675.
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